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DSH140228D SWEDISH AMERICAN HOSPITAL (Active)
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Main Details
Name
SWEDISH AMERICAN HOSPITAL
Subdivision Name
HOME HEALTH AGENCY - UWNI SAH HOME HEALTH INTERMITTENT SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140228D
Medicare Provider Number
140228
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/27/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
SwedishAmerican Hospital
Patricia Ann DeWane, Vice President, Finance and Treasurer
(779) 696-4009
Primary Contact
SwedishAmerican Hospital
Tom Carey, Director of Pharmacy Services
(779) 696-4580
Addresses
Street Address
2550 CHARLES ST
STE A
ROCKFORD, IL 61108
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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